Promoting help-seeking using e-technology for adolescents with mental health problems: Results from a RCT within the ProHEAD Consortium

Mental health problems (MHP) are common in adolescents. Help-seeking behavior (HSB) in this age group is low. An online intervention promoting HSB in adolescents with MHP (ProHEAD-Online) was evaluated in a randomized controlled trial. It was hypothesized that adolescents allocated to ProHEAD-Online would show increased real-world HSB after 12 months compared to adolescents in the control group. A multicenter randomized controlled trial was conducted in a school-based community setting in Germany. n = 1470 students (≥12 years, 74.6% female) with MHP and no HSB at baseline were randomized (ProHEAD-Online: n = 739; control: n = 731). Professional HSB of 4.5% (control) and 5.7% (ProHEAD-Online) was reported at the primary endpoint (OR = 1.27, 95% CI = [0.78, 2.10], p = 0.34 ). Age at baseline moderated the treatment effect (OR = 0.79, 95% CI = [0.64, 0.97], p = 0.03 ), ProHEAD-Online only improved HSB in younger adolescents. No significant differences by treatment arm on secondary outcomes (i.e., severity of MHP, health-related quality of life, attitudes toward help-seeking, perceived barriers to help-seeking, help-seeking intentions, and treatment satisfaction). Professional HSB in adolescents with MHP is low. An online intervention to increase HSB in adolescents with MHP was not superior to static online content. Improving HSB, particularly among older adolescents, remains challenging.